Lumpectomy As Good As Mastectomy, Study Finds

April 20, 1994|Los Angeles Times

In a study that could provide reassurance to many breast cancer patients, researchers have confirmed that lumpectomy - in which only the tumor, rather than the entire breast, is removed - is as effective as mastectomy.

But the research also found that many women who are eligible for the procedure do not get it.

The findings come on the heels of a controversy over falsified data in an international breast cancer study that advocated lumpectomy in conjunction with radiation therapy.

Experts hope the new results will comfort lumpectomy patients who wonder if they made the right choice.

Yet the University of California, Irvine, study of 5,892 Orange County women in 126 Southern California hospitals may also be troubling.

The researchers uncovered stark disparities in the way breast cancer patients are treated. They found that whether a patient lived or died after surgery depended in part on the type of hospital in which she received care. Those in large hospitals fared the best.

"This again emphasizes that lumpectomy and radiation is very acceptable therapy," said Dr. Harmon Eyre, chief medical officer for the American Cancer Society. "But the second message is that you want to have cancer care given in an institution where they pay attention to quality of care, and those are generally the large institutions with the larger number of cases."

The Irvine study, published in today's Journal of the American Medical Association, examined medical records for white women whose breast cancer was diagnosed between 1984 and 1990. It is the first in the nation to compare the treatment and survival of breast cancer patients by hospital type.

The Irvine study found that patients in large hospitals - those with more than 200 beds - fared the best. They were 26 percent less likely to die in the five years after surgery than those who had lumpectomies or mastectomies in small hospitals.

Patients in HMO hospitals, both large and small, fared poorly, researchers found.